Online Registration

At iCare Medical, we understand that wait times at doctors offices and ER's can take hours! By filling out this form ahead of time, we hope to speed up the process and be able to see you right away when you walk through the door at our office. 
Once the form is submitted, we will contact you via telephone with a specific time to come  in and be seen!
The more data you include the less will be needed to complete when you come-in. If you were seen at any iCare before then you don't need to re-submit the same data unless the ones that need updated.
Please note our office hours. If we are closed when this form is submitted, we will contact you as soon as we open in the morning!
All information will be kept confidential in compliance with the Heath Insurance Portability And Accountability Act of 1996 (HIPAA)

If patient is under 18-year old